Performance Improvement Plans

The HPC works to monitor the performance of individual payers and providers against the Commonwealth’s health care cost growth benchmark, and may require payers and providers with excessive spending growth to implement a performance improvement plan.

The Health Policy Commission (HPC) and the Center for Health Information and Analysis (CHIA) share responsibility for monitoring health care spending in Massachusetts and measuring performance against the health care cost growth benchmark. In addition to evaluating performance for the Commonwealth as a whole, the agencies review individual payer and provider group spending performance through the Performance Improvement Plan (PIP) process. The PIPs process is one of the key enforcement mechanisms included in Chapter 224 of the Acts of 2012, the Commonwealth’s landmark cost-containment law, and began in 2016.

Performance Improvement Plan Process Overview

Statute, Regulations, and Guidance

• M.G.L. c. 6D, § 10
• 958 CMR 10.00: Performance Improvement Plans
• Policy 2017-01 Process for Performance Improvement Plans

PIPs Forms

• General Instructions (958 CMR 10.02)
• Performance Improvement Plan - Proposal Form (958 CMR 10.02) 
• Performance Improvement Plan - Entity Contact Information (958 CMR 10.02)
• Performance Improvement Plan - Request for Waiver (958 CMR 10.02)
• Performance Improvement Plan - Affidavit (958 CMR 10.02)
• Performance Improvement Plan - Request for Extension (958 CMR 10.02)

Entities Currently Required to File a PIP

• Mass General Brigham

Live MGB PIPs Tracker

• Live MGB PIPs Tracker